Lorraine Clifford-Lee (Fianna Fail) | Oireachtas source

The Minister is very welcome on this day to mark International Women's Day. We are, of course, discussing a very important topic. It is one in which I know she will excel in her role as Minister for Health. The previous Minister, Stephen Donnelly, changed the landscape for women's health in Ireland during his term of office. I am sure she will continue that very good work and expand on the very many good schemes that were started. However, it is step-by-step, incremental change and, as was pointed out, this is a community issue rather than a women's issue. It impacts everybody in our community and the women in our lives - the women who are caring, teaching and working in our workplaces - and it is right and proper that proper investment is made because, unfortunately, like many things, we are fighting the patriarchy and it manifests in the lack of investment in women's healthcare over the years.

The free contraception scheme really changed the playing pitch for women in Ireland. Since the days of the contraception train going to Belfast, I did not think we thought we would see in a relatively short period of time free contraception for women in this country from the ages of 17 to 35. That was really ground-breaking. However, I would like to ask the Minister what the plans are to extend this to 16-year-olds. I know the previous Minister, Stephen Donnelly, had started working on that and was receiving advice from the Attorney General. Where is that body of work at? Will we be able to expand it upwards beyond the age of 35 because, of course, we know that women over the age of 35 still have a need for contraception? Oftentimes, when people are paying for a lot of things in their lives - expensive rent, mortgage payments, children, childcare and everything else - it can be very expensive for that age group. I would really appreciate if the Minister could give us an update in that regard.

Safe access zones were something many of us in this House worked upon in the last term. I am very glad safe access zones have been put in place to protect women who are availing of termination services and services in our maternity units. The gynaecology see and treat clinics have been a huge success and have really brought down gynaecology waiting lists. The menopause hubs have also been very well received. I know people who have accessed treatment there and they speak very positively. As people have mentioned, the roll-out of the HRT scheme is one thing but the HRT shortages is also something that is coming into sharp focus. There was a recent announcement that Estradot, one of the most widely used HRT patches, will be in short supply for much of 2025 and 2026. This has left women across Ireland feeling very anxious and abandoned. For many women, simply switching to another HRT product is not viable. HRT is not a one-size-fits-all treatment and many women have spent many years finding a product that works for them and coming up with a formula with their doctors to see what works for them. Therefore, the prospect of losing access to this very important drug is very concerning. The Minister might address what specific steps the Department of Health is taking to address these shortages. This then will ensure a long-term, stable supply of this really vital drug.

The free IVF scheme, again, was absolutely ground-breaking and many in this House worked very hard on that, but the expansion of the scheme is something that needs to be looked at. I would appreciate it if the Minister could address that. We know we needed to start with a limited form of free IVF. I am delighted that many couples who availed of the free IVF now have their bouncing babies in their arms, but we need to ensure that more people have access to this. We are facing a population crisis globally, but in the western world as well, and we need to help families to have as many children as they want to have. A lot of people might be able to have one child, but they are suffering from secondary infertility, and it is really important that those people can avail of the free IVF scheme.

Endometriosis was also referred to by a number of people here. One in ten Irish women, unfortunately, suffers from endometriosis. A national framework of endometriosis is currently in train. Could the Minister give us an update as to when this will be published? Education for GPs around endometriosis care needs to be mandatory.Many GPs have taken it upon themselves to upskill and engage in education in this area, but not all of them have done so. It is very difficult for people to switch GP if they find the doctor they are attending does not have skills, knowledge or interest in endometriosis. That applies particularly in Dublin but also in other parts of the country. Education and training should be mandatory. There also should be access to holistic care for patients suffering from endometriosis. Surgical treatment is one option but people might also need to avail of other, holistic therapies. Those therapies should be available to women without charge.

I am really glad the Minister mentioned bone health and cardiovascular health in her opening statement. I included a reminder in my notes to raise those issues and the importance of weight-bearing exercise for women as we age. That will mitigate against osteoporosis, brittle bones, falls, bumps and everything women experience as they move into the later years.

As the Minister noted, 18 out of 19 hospitals now provide termination of pregnancy services. That is very welcome. Cavan General Hospital is the one hospital still to begin providing the services. I understand they will become available at the end of March. Can the Minister indicate whether that is still the date?

There is an issue with women being gaslighted and not listened to when they access the health service. This is a particular issue for ethnic minorities and women of colour. We have seen that in other countries and it is becoming more prevalent in Ireland. There needs to be education and training through which biases within the health service are examined.

Shortages of public health nurses, particularly in areas of booming population such as my area of north County Dublin, are really impacting on women. When women are at home with small children, particularly their first child, it is a very vulnerable time of life. Women often have a toddler and a newborn at home and are unable to access the public health nurse service to which they are entitled. Other Members have raised this issue in the past. I hope the Minister can give us comfort that more public health nurses are being recruited, trained and deployed, particularly to areas of growing population.

The goal that was set of eliminating cervical cancer is achievable with access to the human papillomavirus, HPV, vaccine. I am glad the vaccination programme has been rolled out. The uptake is quite good but there are still some problems in that regard. There was a lot of vaccine hesitancy and there still is such hesitancy in regard to this particular vaccine. Much work is still needed in that area.

The lung cancer pilot screening project, in which north Dublin is included, is very welcome. I hope it will be rolled out to other parts of the country. As the Minister said, women suffer in particular from lung cancer.

A constituent contacted me recently regarding the repeated cancellation of vital surgery she is awaiting to correct very serious injuries she sustained while giving birth. Those injuries have been very impactful on her life and on the lives of her family. However, these surgeries are seen as non-urgent. This woman has repeatedly faced her surgery being cancelled. I ask that it be made a matter of priority to secure treatment for women who have suffered injuries during birth, which can be really horrific, wide-ranging and impactful on day-to-day life. Such surgeries must be seen as a priority and not something that can be cancelled and put on the long finger.

I suffered from hyperemesis during pregnancy. Those who have served with me here in the Seanad over the years know this is something on which I have campaigned. Mine was a lone voice for a long time. Cariban made a significant difference to my life and I am glad the medicine is now available on the general medical services, GMS, scheme. As my colleague pointed out, we need a public awareness campaign to inform people that this drug is available and is safe to use. Given the experience with other drugs in the past, many women are reluctant to take Cariban. It is a very safe drug and it can be life changing for women suffering from hyperemesis.

I have loads of other points to make but my time is up. We will have more time with the Minister in the future to discuss this really important topic. I thank her for coming to the House. I hope she will work with us to progress all these issues.